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8250 E LADYFERN LNPermit Types • BLD ELE MEC PLM X Permit Number: BLD2023-00363 Issued: 01/24/2023 www.anaheim.neUbuilding (714)765-0626 Quarter Section: 220 Site Address: 8250 E LADYFERN LN, ANAHEIM, CA 92808 Legal Description: N TR 12992 BLK LOT 49 AFN:35438220 CITY OF ANAHEIM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 Project Description: Reroof: Relay (32) sq It of existing tile over the entire house Living Area: Number of Stories: 1 Valuation: 13,650.00 Garage Area: Construction Types: NIA Carport Area: Occupancy Groups: Balcony I Deck Area: Fire Spdnklered: Cool Root: Total Fees paid for Permit: 707.77 People Associated with Project: Owner JACOBS DOUG C II & STEPHANIE A 8250 E LADYFERN LN Type Electrical Fixtures Qty Type Plumbing Fixtures City Mechanical Fixtures City The perrrrlt shall expire by limitation and become null and void If the building or work has not passed final Inspection 365 days from the date of permit Issuance. A new permit Is required to commence or continue work. City of Anaheim Building Division Do not occupy this buildina until the final inspections have been made. INSPECTION DATE I INSPECTOR Do not pour concrete until the following applicable items have been signed: Plumbing (Ground/Underfloor Drain Waste) Electrical Ground Electrode/Ufer Setback/Forms/Trenches (Footings) Do not install subfloor or pour floor slab until the follwing applicable items have been sinned: Plumbing (Ground/Underfloor Water) Underfloor Rough Gas Mechanical (Groundwork) Electrical (Underground Conduit) Pre -slab (Compaction/Membrane Reinf.) Floor (JoisUGirders) Underfloor Insulation (Raised Foundation Only) Floor Nailing (Raised Foundation Only) 2nd Floor (Floor Nailing) Do not cover or conceal the work below until the following applicable items have been sianed7 1st Floor Shear Firesprinkler (Rough) (Fire Dept.) 2nd Floor Shear Roof (Sheathing/Diaphragm/Frame) Masonry (Reinf./Bond Beam/Pre-Grout) Rough Plumbing (Top Out) Rough Duct (Mechanical) Rough Mechanical Rough Electrical Rough COAIMitagation Measures Framing (Only after Plbg., Ele., Mec. & Fire) Insulation (Sound/Energy) Do not tape or plaster until the following applicable items have been signed: Drywall Drywall Penetrations (Ele, Mec & Plbg) Interior Lath Exterior Lath Electrical Service Meter -(Meter will be set within 2-3 business days after approval) Excludes New Construction Exterior Plaster (Brown Coat) T -Bar (Struct., Ele., or Mec.) Grease Interceptor Sewer Water Engineering Backflow (Testable Only) Water Service FINAL INSPECTIONS DATE I INSPECTOR All applicable items below must be signed before utilities are released Final Gas Test Electrical Final Plumbing Final Mechanical Final Cross Connection Control (714) 765-4280 Engineering Final (714) 765-5126 Fire Sprinkler (ONLY) (714) 765-5041 Fire Dept. Final (714) 765-5041 Water Engineering (714) 765-4591 Sub List/Bus. Lic. (714) 765-5194 (Allow 10 business days) COA/Migation Measures Building Final (714 765-5153) Last Inspection -Final Only After Above Completed Q 80�ZIAH PARTIAL INSPECTIONS Buildina Inspections Mechanical Inspections Plumbing Inspections Electrical Inspections WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES A FOR IN SECTION 3706 OR THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES. S PROVIDED I hereby affirm under penalty of pedury one of the following declarations: Permit Types I have and will maintain a certificate of consent to selMnsure for worker's compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Is issued. I I have and will maintain workers compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the I ` this permit is issued. My workees Compensation insurance carrier and policy are. work for which Cartier: STATE COMPENSATION INSUR C cUNp Policy No.: 9316111 Expiration Date:22103 Name of Agent Phone No.: I certify that in the performance of the work for which this permit is issued, I shall not employ an worker's compensation I of California, and agree that, it I should become subject to the worker's compensation provisions of Section 3700 of the P oy y person in any manner so as to become subject to the Labor Code, II th comply with those provisions, ure of Applicant Date DECLARATION REGARDING CONSTRUCTION LENDING AGENCY: I hereby afire under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit Is issued (Sec.3097.Civ.C): Lender's Name: Lender's Address: LICENSED CONTRACTOR'S DECLARATION: I hereby aft Code, and my liceunder the penalty of Perjury that I am licensed under provisions.o Professions Code, 9 (commencing with Section 7000) of Division 3 of the Business and nse is in force and efect._-- ,.r I Sign to I Date NUMBER EXPIRATION DATE _ LICENSE_ jP icy 1089382 04/30/2024 C39